Background: Vascular inflammation plays a role in the development of atherosclerosis. Elevated high-sensitivity C-reactive protein (hs-CRP) as a useful marker of inflammation and increased carotid intima-media thickness (IMT) have been associated with increased risk of coronary artery disease and future cardiovascular events. We evaluated the association of hs-CRP and carotid IMT in patients with coronary artery disease. Methods: Total 688 consecutive patients (mean age 59.5  10.6 years, 383 males) undergone coronary angiography with coronary artery diseases were enrolled. The carotid IMT was assessed by measuring semi-automatically using high-resolution ultrasound. Blood samples were collected for hs-CRP measurement. Results: The hs-CRP significantly correlated with carotid IMT (r= 0.116, p= 0.002). Also age (r=0.336, p<0.001), fasting blood glucose (r=0.166, p<0.001), low-density lipoprotein cholesterol (r= 0.099, p=0.009), fibrinogen (r=0.125, p=0.001), left ventricle ejection fraction (r=-0.088, p=0.021), and left ventricle mass (r=0.105, p=0.007) correlated with carotid IMT. In the multivariate linear regression analysis, hs-CRP was an independent predictor of carotid IMT (beta coefficients 0.08, 95% CI 0.006-0.102, p=0.027). Conclusion: Elevated hs-CRP is significantly associated with increased carotid IMT in coronary artery disease. CRP may be a useful predictor of ongoing inflammation in manifested atherosclerotic disease.